WO2015099090A1 - Dispositif d'amélioration de fonctions endothéliales vasculaires - Google Patents

Dispositif d'amélioration de fonctions endothéliales vasculaires Download PDF

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Publication number
WO2015099090A1
WO2015099090A1 PCT/JP2014/084413 JP2014084413W WO2015099090A1 WO 2015099090 A1 WO2015099090 A1 WO 2015099090A1 JP 2014084413 W JP2014084413 W JP 2014084413W WO 2015099090 A1 WO2015099090 A1 WO 2015099090A1
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Prior art keywords
pressure
electrical stimulation
pressurization
period
stimulation
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PCT/JP2014/084413
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English (en)
Japanese (ja)
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純生 山田
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国立大学法人名古屋大学
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Priority to JP2015555027A priority Critical patent/JPWO2015099090A1/ja
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H9/00—Pneumatic or hydraulic massage
    • A61H9/005—Pneumatic massage
    • A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1107—Measuring contraction of parts of the body, e.g. organ, muscle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/10—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1635—Hand or arm, e.g. handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5071—Pressure sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/06—Arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2205/00—Devices for specific parts of the body
    • A61H2205/10—Leg
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2209/00—Devices for avoiding blood stagnation, e.g. Deep Vein Thrombosis [DVT] devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/30—Blood pressure

Definitions

  • the present invention relates to a vascular endothelial function improving apparatus capable of improving the vascular endothelial function of an artery without performing exercise.
  • a vascular endothelial cell is a layered tissue composed of flat and thin cells constituting the inner surface of a blood vessel of a living body.
  • the vascular endothelial cells have functions of regulating the contraction and relaxation of the vascular wall, adhesion of inflammatory cells to the vascular wall, vascular permeability, coagulation / fibrinolysis, and the like.
  • the function of such vascular endothelial cells is easily affected by living conditions such as food and exercise in the living body, and can be significantly reduced by, for example, hypertension, diabetes, lifestyle-related diseases and the like.
  • the state in which the vascular endothelial function is lowered continues, the progression of arteriosclerosis and the instability of plaque (atheroma) may be caused, and the health state of the living body may be impaired. Therefore, in maintaining the healthy state of the living body, it is necessary to grasp the state of the vascular endothelial cells and to improve the function when the vascular endothelial function is lowered, thereby improving the vascular function and thus the health of the living body. It can be said that it is extremely important to improve the state.
  • vascular endothelial cells As a technique for examining the state of such vascular endothelial cells, for example, a blood flow-dependent vascular dilation (FMD) test method is known, and ultrasonic waves output to blood vessels before and after ischemia are known. Based on the reflected signal, various functions of vascular endothelial cells are evaluated from the state of dilation of blood vessels when blood flow is resumed.
  • FMD blood flow-dependent vascular dilation
  • Patent Documents 1 and 2 are known as conventional techniques related to an apparatus for evaluating the vascular endothelial function.
  • Patent Document 1 in the FMD examination method, when creating an ischemic state in a part of a living body, by applying exercise load or heat to the distal side of a part irradiated with ultrasonic waves of the living body, It is disclosed that the transition to an ischemic state can be accelerated. And, as a loading device for applying such exercise load, the current is applied to the living body to make the muscle move (static exercise), and the muscle is exercised by grasping the hand of the living body (dynamic exercise) ) Is disclosed as preferred. However, the above-mentioned device is for evaluating the state of the vascular endothelium and does not enhance the vascular endothelial function itself.
  • the present invention was created to solve the above-described conventional problems, and the object of the present invention is to improve a vascular endothelial function improving device capable of improving the vascular endothelial function of an artery without performing dynamic exercise. Is to provide.
  • a vascular endothelial function improving device includes pressure applying means for applying a pressure that inhibits blood flow to some arteries of a living body, and electrical stimulation that can induce contraction of the muscles to the muscle including the arteries. And an electrical stimulus applying means for applying.
  • the pressure applying means is configured to apply pressure intermittently by a pressurization period in which pressurization is performed on the artery and a rest period in which the pressurization is released. Yes.
  • the electrical stimulation applying means is configured to apply electrical stimulation to the muscle during a period including at least a part of the rest period.
  • the arterial blood flow is inhibited by compressing a part of the living body by the pressure applying means, and blood is accumulated on the central (upstream) side of the compressed site, and more peripheral (downstream) side. Suppresses blood flow.
  • the muscle including the artery is contracted by the electrical stimulus applying means to compress the artery.
  • the outflow of the accumulated blood due to the release of the pressure and the extrusion of the blood due to the contraction of the muscle are simultaneously performed, and a rapid change can be brought about in the blood flow velocity of the artery.
  • Such a blood flow velocity can give a sufficiently strong shear stimulus (shear stress) to the arterial endothelium, so that, for example, the arterial endothelial function can be improved without excessive compression.
  • muscle strength can be increased by static exercise.
  • intermittent pneumatic compression is known as one of the physical methods for preventing known venous thromboembolism and the like.
  • Such a technique increases the blood flow velocity of a vein in the compressed state by compressing a part of the living body, and enhances the antithrombotic action by preventing the blood accumulation in a vein such as a flounder vein that is likely to cause an intravenous thrombus. Is.
  • this method it is possible to prevent blood accumulation in veins circulating in the low-pressure system, but it is difficult to obtain a blood flow velocity that enhances the endothelial function of the artery circulating in the high-pressure system.
  • the electrical stimulation applying means applies the electrical stimulation on a central side with respect to a site to which pressure is applied by the pressure applying means.
  • the artery present in the muscle is compressed by contracting the muscle closer to the center than the compression site. This is preferable because the accumulated blood can be pushed out instantaneously at a large flow rate due to muscle contraction, and the blood flow velocity on the downstream side can be increased more rapidly than the site where electrical stimulation is applied.
  • the pressure applied to the artery is the blood pressure (ie, the blood pressure of the artery) when the systolic blood pressure is SBP (systolic blood pressure) (SBP + 10 ) To (SBP + 50) mmHg.
  • SBP systolic blood pressure
  • SBP + 10 systolic blood pressure
  • SBP + 50 mmHg
  • systolic blood pressure is defined as the maximum pressure during ventricular contraction at rest, unless otherwise specified, and blood pressure of an indirect method (also referred to as noninvasive or noninvasive). It can be measured using a meter.
  • systolic blood pressure is, for example, a blood vessel sound synchronized with a heartbeat that is heard when an artery opens and blood flows when releasing the pressurization after compressing the artery of the upper arm with a cuff provided in a sphygmomanometer ( It can be calculated as the cuff pressure when the Korotkoff sound begins to be heard.
  • the average systolic blood pressure of a normal healthy adult male is, for example, about 120 mmHg and about 110 mmHg for an adult female.
  • the numerical range when the numerical range is indicated as “lower limit value to upper limit value” using the symbol “ ⁇ ” as described above, the numerical range means “lower limit value or higher and lower limit value or lower”.
  • the electrical stimulation applied to the muscle is set to a stimulation intensity that induces exercise of 5 to 30% of the isometric maximum muscle strength. It is said. According to such a configuration, the blood flow can be further pushed out effectively without applying an excessive burden on the muscle. Thus, for example, even when electrical stimulation is intermittently applied repeatedly for 5 minutes or more (exceeding 5 minutes), the arterial endothelial function can be improved without causing fatigue due to excessive static exercise. it can. In addition, it is possible to effectively increase muscular strength by static exercise.
  • the “isometric maximum muscle strength” is the maximum value of the force exerted by the muscle contracting in a state where the joint angle or the muscle length is kept constant. The muscle strength measured by the measurement or the back muscle strength measurement corresponds to this.
  • the pressure applying means applies the pressure so that the pressurization strength in the pressurization period changes with time.
  • the said electrical stimulation provision means makes the pressure when the said pressurization intensity
  • the electrical stimulation is configured to be applied with the start of the rest period. According to this configuration, since the electrical pressure is applied to the muscle at the same time as the pressurization by the pressure applying means is released, the blood accumulated by the pressurization is effectively downstream from the pressurization site while suppressing an increase in blood pressure. Can be extruded.
  • the pressure applying means includes a second electric stimulation applying means capable of applying electric stimulation to a site to which the pressure is applied. It is a feature. This configuration is preferable because the blood flow velocity can be increased by muscle contraction even at the pressure application site.
  • the device when the part of the living body includes any one or more limbs of the living body, the device further includes a fixing tool, and the fixing tool includes the limb of the limb. It is characterized by restraining the reflex movement of the said limb by the said electrical stimulation by fixing at least any one limb. According to this configuration, it is possible to improve the vascular endothelial function without inflicting damage such as bruises on the extremities of the living body.
  • the pressurization period is any time defined between 5 seconds and 15 seconds, and the rest period is 15 seconds to 45 seconds. It is characterized by being any time determined between. According to such a configuration, an appropriate amount of blood can be accumulated and then flowed at a stroke. In addition, even when the pressurization period and the rest period are repeatedly performed, an excessive burden is not imposed on the living body, and thus it is possible to generate a shearing stimulus in the artery for a long time as a whole. The function can be improved sufficiently. Or, by repeating the pressurization period and rest period, it is possible to effectively generate shear stimulation without causing muscle fatigue, so it is possible to generate a certain amount of shear stimulation in a shorter time. It becomes.
  • the part of the living body is at least one selected from the group consisting of left and right upper limbs and left and right lower limbs.
  • the intermittent pressurization by the pressurization period and the rest period is performed for 5 minutes or more. This configuration is preferable because the blood flow in the artery due to compression can be easily and effectively performed.
  • it can effectively improve the arterial endothelial function of the lower limbs for patients and victims with limited upper limb and lower limb movements, especially those who are difficult to walk on their own. This is preferable because it can be enhanced.
  • the technique disclosed here can be grasped as applying pressure and applying electrical stimulation to a predetermined position of a living body at an appropriate timing.
  • the technology disclosed herein can be understood as a stimulus control method of pressure stimulation (compression stimulation) and electrical stimulation for improving the vascular endothelial function of a living body. That is, the technique disclosed herein provides a method for controlling stimulation of pressure stimulation and electrical stimulation that can suitably improve vascular endothelial function.
  • Such a device can be applied to a living body suffering from a lifestyle-related disease such as hypertension, diabetes, and metabolic syndrome, thereby effectively improving or preventing the decreased endothelial function of arteries.
  • a lifestyle-related disease such as hypertension, diabetes, and metabolic syndrome
  • the endothelial function of the artery is effectively improved. Strengthening of the muscles including it can also be achieved. From this viewpoint, the technology disclosed herein can be understood as a method for improving the vascular endothelial function of a living body.
  • FIG. 1 is a mimetic diagram which illustrated signs that arterial endothelial function of a leg is improved using a vascular endothelial function improvement device which is one embodiment.
  • FIG. 2 is a schematic view illustrating a state in which the arterial endothelial function of the upper limb is improved using a vascular endothelial function improving device according to another embodiment.
  • FIG. 3 is a schematic view illustrating a state in which the arterial endothelial function of the lower limb is improved using a vascular endothelial function improving device according to another embodiment.
  • FIG. 4 is a schematic view illustrating a state in which the arterial endothelial function of the upper limb is improved using a vascular endothelial function improving device according to another embodiment.
  • FIG. 2 is a schematic view illustrating a state in which the arterial endothelial function of the upper limb is improved using a vascular endothelial function improving device according to another embodiment.
  • FIG. 3 is a schematic
  • FIG. 5 is a diagram for explaining the operation of the vascular endothelial function improving device disclosed herein.
  • FIG. 6 is a diagram for explaining the action of shear stress on the vascular endothelium.
  • FIG. 7 is a diagram for explaining a control mode of compression and electrical stimulation by the vascular endothelial function improving device disclosed herein.
  • FIG. 8 is a diagram illustrating a control mode of compression and electrical stimulation disclosed herein.
  • FIGS. 1 to 4 are schematic diagrams for explaining the configuration of the vascular endothelial function improving device 1 disclosed herein.
  • the vascular endothelial function improving device 1 includes a pressure applying unit 10 that applies a pressure that inhibits blood flow to a part of an artery of a living body, and an electric that can induce contraction of the muscle with respect to a muscle including the artery. And an electrical stimulus applying means 20 for applying a stimulus.
  • the vascular endothelial function improving device 1 may include a control unit 30 that controls the pressure applying unit 10 and the electrical stimulation applying unit 20 in an integrated manner.
  • the control unit 30 as an external device may be configured to be connectable by wire or wireless so that various information can be transmitted and received.
  • the vascular endothelial function improving device 1 is connected to a personal computer as an external device including the control unit 30 so as to enable bidirectional communication.
  • the vascular endothelial function improving device 1 includes a control unit 30 in the device.
  • the pressure applying means 10 typically introduces, for example, a cuff body 12 for compressing a part of the living body and air or the like to the cuff body 12 so that the cuff body 12 can exert a pressurizing action.
  • the pressurizing pump 14 and the cuff pressure control means 16 for controlling the pressure by the cuff can be mainly configured.
  • the cuff body 12 is a bag-like belt called manchette or the like.
  • the cuff body 12 is wound around a limb such as a lower limb 52, 54 or an upper limb 56, 58 of a subject 50 as a living body, and is used in a bag. When air or the like is introduced into the body, it expands and presses the limb.
  • the pressurizing pump 14 has a function of introducing a gas such as air into the cuff body 12 via a tube or the like.
  • the cuff pressure control means 16 includes an exhaust valve (not shown) having a function of opening and closing a path for introducing air or the like into the cuff body 12, and the pressure of a gas such as air introduced into the cuff body 12 (so-called cuff). It may be equipped with a function such as a pressure gauge (not shown) capable of measuring (pressure).
  • the cuff body 12 can be mounted on, for example, the lower limbs 52, 54 of the subject 50 who is lying on a bed or resting in a long sitting position or a semi-sitting position.
  • cuff bodies 12R and 12L are mounted on the calf portions of the right lower limb 52 and the left lower limb 54 (not shown) of the subject 50, respectively.
  • cuff bodies 12R and 12L are attached to the forearms of the upper right limb 56 and the left upper limb 58 (not shown) of the subject 50, respectively.
  • the cuff body 12 can inhibit arterial blood flow in the calf part by pressing the calf part on the left and right of the subject 50, for example.
  • the cuff body 12 can be used without particular limitation as long as it can compress a part of the subject 50 and inhibit the blood flow of the artery included in the compressed region.
  • a latex or non-latex elastic band used for blood collection or the like, or a tourniquet represented by a cuff (compression band) used for a blood pressure monitor or the like is preferably used. be able to.
  • It is more preferable to use a non-latex velcro-type cuff because it is easy to attach and detach and can suppress skin irritation to the subject 50 having a chemical allergy.
  • this cuff can be connected to a sphygmomanometer from the viewpoint of controlling the applied pressure described later.
  • the cuff pressure control means 16 can detect the cuff pressure and control the driving of the pressurizing pump 14 and the opening / closing of the exhaust valve so that the cuff pressure becomes a predetermined value. That is, according to a command from the cuff pressure control means 16, air is introduced from the pressurizing pump 14 into the cuff body 12 to pressurize the limb, or the exhaust valve is opened to discharge air from the cuff body 12. Or release the pressure on the.
  • the cuff pressure control means 16 may be connected to the control unit 30, operates the exhaust valve and the pressurization pump 14 at a predetermined timing based on an instruction from the control unit 30, or measures the cuff pressure measured with a pressure gauge. Data such as pressure can be sent to the control unit 30.
  • FIG. 1 and 2 illustrate a configuration in which a pressurization pump 14 is provided separately from the cuff body 12, and the pressurization pump 14 sends air to the cuff body 12 via a tube or the like.
  • the configuration of the pressure applying means 10 is not limited to this.
  • a pressurizing pump 14 may be provided integrally with the cuff body 12.
  • the cuff body 12 may be provided with a second electrical stimulus applying means 18 different from the electrical stimulus applying means 20.
  • the cuff body 12 may be configured to be attachable from the lower leg to the foot. And it can be set as the structure which can pressurize at least one part of a midfoot part (arch part) among legs. By pressurizing the midfoot part, an effect of effectively improving the plantar peripheral circulation is seen.
  • the front foot part (including the toes) and the rear foot part (the heel part) of the foot part may be configured such that one or both of them can be pressurized by the cuff body 12, and this part is the cuff body 12.
  • the structure exposed from may be sufficient.
  • the electrical stimulation applying means 20 can typically be constituted mainly of, for example, at least one pair of conductor portions 22 and a power supply 24 that supplies current to the conductor portions 22.
  • the conductor portion 22 is formed in a pad shape having adhesiveness, and may be attached to the skin of a living body by adhesive force.
  • the pair of conductor portions 22 are brought into contact with the skin of the living body, and an electric current is applied to the muscles of the living body included in the region where the current flows by supplying a current from the power source 24 to the conductor portion 22. be able to.
  • the electrical stimulation applying unit 20 there is no particular limitation on the other configurations of the electrical stimulation applying unit 20 as long as it can apply electrical stimulation to muscles including an artery to which pressure is applied by the pressure applying unit 10.
  • the mounting position is not particularly limited. Therefore, electrical stimulation may be applied to the muscle including the artery on the central side (also referred to as upstream side, proximal side, etc.) from the pressure application position, or the distal side (downstream side) from the pressure application position. , Also referred to as distal), electrical stimulation may be applied to the muscle including the artery.
  • the conductor portion 22 may be attached to the central side (upstream side) of the portion to which the pressure is applied by the pressure applying means 10, or may be attached to the distal side (downstream side).
  • the central side means the upstream side of the arterial blood flow with respect to the site where pressure is applied by the pressure applying means 10 in the living body.
  • it may be a large muscle group that includes an artery that is a target of pressure load, which is a higher rank of the major joint immediately upstream of the pressure application site.
  • the pressure applying means 10 and the electrical stimulation applying means 20 can be in an appropriate positional relationship, for example, and suitably apply pressure and electrical stimulation to the living body. can do. Therefore, the muscle to which electrical stimulation is applied and the muscle to which pressure is applied need not be the same muscle.
  • the electrical stimulus applying means 20 is attached to the thigh part on the center side.
  • the conductor portions 22R and 22L are attached to the thighs of the right lower limb 52 and the left lower limb 54 (not shown) of the subject 50, respectively.
  • the electrical stimulus applying unit 20 is mounted on the central upper arm. Then, conductor parts 22R and 22L are attached to the upper arms of the upper right limb 56 and the left upper limb 58 (not shown) of the subject 50, respectively. For example, by applying electrical stimulation to the left and right thighs of the subject 50, the muscle including the artery passing through the thighs can be contracted by the electrical stimulation applying unit 20.
  • the electrical stimulation which can contract a muscle effectively can be provided by supplying a pulse-form electric current.
  • the power source 24 can supply a pulsed current between the pair of conductors 22 at a predetermined timing, and can contract or relax muscles in response to electrical stimulation based on the current. Can do.
  • the power source 24 may be connected to the control unit 30 and can supply a current having a predetermined intensity and waveform to the conductor unit 22 at a predetermined timing based on an instruction from the control unit 30.
  • the conductor portion 22 may be provided with two poles as a set.
  • One electrical stimulus imparting means 20 is provided with at least one set of conductor portions 22 and may be provided with two or more sets (for example, four sets) of conductor portions 22. Any number (set) of these may be configured to be detachable from the apparatus 1.
  • the electrical stimulation applying means 20 can be used without particular limitation as long as it can induce contraction of muscles included in the stimulation applying region by applying electrical stimulation to a part of the subject 50. .
  • the thing which can give an electrical stimulus by flowing an electric current is mentioned.
  • the current may be a direct current, an alternating current, or a bipolar current.
  • the power source 24 is not particularly limited.
  • the frequency is preferably a low frequency of 1 Hz to less than 1000 Hz, a medium frequency of 1000 Hz or more, or 10,000 Hz.
  • It may be an oscillator or the like that can generate the above high frequency. More preferably, a low-frequency oscillator or the like that can oscillate a low frequency with a frequency of about 1 to 500 Hz with an arbitrary pulse waveform is preferable.
  • the second electrical stimulus applying means 18 provided in the pressure applying means 10 can also be configured in accordance with the electrical stimulus applying means 20. That is, it may be various electric stimulus applying means capable of applying an electric stimulus capable of inducing muscle contraction to a part of the living body.
  • the electrical stimulation applied to the living body by the second electrical stimulation applying means 18 may have the same strength as the electrical stimulation applied by the electrical stimulation applying means 20 or may be applied by the electrical stimulation applying means 20. It may be more gradual than electrical stimulation.
  • By providing such second electrical stimulation applying means 18 in the cuff body 12 for example, it is possible to apply an electrical stimulation having an arbitrary strength and form to the living body part that has been compressed by the pressure applying means 10. . For example, it is possible to provide a massage effect that relieves fatigue and stiffness of muscles of a living body part that has been compressed by the pressure applying means 10.
  • control unit 30 stores various data received from the pressure applying unit 10 and the electrical stimulus applying unit 20, or performs predetermined computation and processing on the data based on various programs such as a system program ( Execution) or instructing the pressure applying means 10 and the electrical stimulus applying means 20 on the timing and intensity of applying the stimulus based on the data after the calculation and processing.
  • the control unit 30 is not particularly limited.
  • various control units such as a central processing unit (CPU), a digital signal processing unit (DSP), and an ASIC (Application Specific (Integrated (Circuit) Circuit), electrical and electronic elements such as IC memory, etc. can be mainly configured.
  • control unit 30 is an external device of the vascular endothelial function improving device 1, the control unit 30 can be configured by a computer such as a personal computer, for example.
  • the vascular endothelial function improving device 1 includes two sets of pressure applying means 10 and electric stimulus applying means 20, and the pressure applying means 10 and the electric stimulus applying means 20 are connected to the left and right lower limbs of the subject 50.
  • the vascular endothelial function improving device 1 is provided with a pair of pressure applying means 10 and electrical stimulation applying means 20, which are connected to the left and right lower limbs 52 and 54. You may make it mount
  • the vascular endothelial function improving device 1 is provided with two or more sets of pressure applying means 10 and electric stimulation applying means 20, and any one of these is applied to one of the left and right lower limbs 52, 54. You may make it wear only.
  • the pressure applying means 10 is attached to the calf part of the subject 50 and the electrical stimulus applying means 20 is attached to the thigh of the subject 50, but these are attached to another part of the subject 50. May be.
  • the pressure applying means 10 is attached to the forearm of the upper limbs 56 and 58 of the subject 50, and the electrical stimulus applying means 20 is attached to the upper arm of the upper limbs 56 and 58 of the subject 50.
  • the pressure applying means 10 is attached to the upper arm of the upper limbs 56 and 58 of the subject 50
  • the electrical stimulus applying means 20 is attached to the forearm of the upper limbs 56 and 58 of the subject 50.
  • the electrical stimulus applying means 20 is attached to the distal side of the pressure applying means 10.
  • the pressure applying means 10 and the electrical stimulation applying means 20 of the vascular endothelial function improving device 1 as described above may be attached to both the left and right upper limbs 56, 58, or either one of them. You may make it mount
  • the pressure applying means 10 may be attached to the lower abdomen of the subject 50, and the electrical stimulus applying means 20 may be attached to the upper abdomen or chest of the subject 50.
  • a part of the subject 50 is compressed by the pressure applying means 10 to inhibit the blood flow of the artery contained in the site. More preferably, a site on the downstream side of the subject 50 is compressed. As a result, blood can be accumulated more centrally than the site to which pressure is applied. For example, such compression acts as if the arterial blood flow is blocked by the dam 110 as shown by the dotted line in FIG. Then, the pressure applied by the pressure applying means 10 is released (depressurized), and the accumulated blood is flowed at a stroke. As a result, blood can flow through the artery at a high speed.
  • electrical stimulation is applied to the muscle including the artery to which pressure is applied by the electrical stimulation applying means 20 to induce contraction of the muscle.
  • the blood flow that has been obstructed so far is further boosted (accelerated) by the action of the muscle contraction (muscle contraction) force in addition to the blood flow due to the release of the compression.
  • This plays a role (muscle pumping action) as if the blood blocked by the dam 110 is pushed out by the pump 120 as the dam 110 is opened.
  • the accumulated blood can be pushed more distally downstream.
  • the blood flow velocity can be further increased by pushing the blood flow by the muscle pump 120 in conjunction with the opening of the dam 110.
  • the blood flow velocity is further increased in the artery of the subject 50 due to the release of compression and muscle contraction.
  • the blood flow at a high speed can give a frictional stress to the endothelial cells constituting the inner surface of an artery, thereby generating shear stimulation.
  • shear stimulation is a physical stimulation generated between the arterial endothelium and the blood flow, and can suitably stimulate the arterial endothelium.
  • the amount can be sufficient to activate arterial endothelial function. As a result, the function of the arterial endothelium can be improved.
  • arteriosclerosis is likely to occur at a site where shear stimulation due to blood flow is small, but by increasing the shear stimulation in the artery to a predetermined intensity or higher by the technique disclosed herein, the generation of arteriosclerosis Can be suppressed or prevented.
  • the compression by the pressure applying unit 10 may generate a load on the subject 50 when continuously performed for a long time, it is preferably performed intermittently. That is, it is preferable to apply pressure intermittently by a pressurization period in which pressurization is performed on the artery and a rest period in which pressurization is released. More preferably, it is more preferable to repeat this pressurization period and rest period alternately several times.
  • the pressure applied to the subject 50 in order to inhibit arterial blood flow is suitably in the range where the blood pressure is about (SBP + 10) to (SBP + 50) mmHg when the systolic blood pressure is SBP.
  • the pressure applied to the subject 50 is preferably (SBP + 40) mmHg or less, and more preferably (SBP + 30) mmHg or less. Further, if the pressure applied to the subject 50 is too low, the blood flow in the artery cannot be sufficiently inhibited, and blood cannot be accumulated on the central side due to such pressure, which is not preferable. Therefore, the pressure applied to the subject 50 is preferably (SBP + 15) mmHg or more, and more preferably (SBP + 20) mmHg or more.
  • the pressure applying means 10 When applying the pressure, the pressure applying means 10 is connected to a sphygmomanometer, and the blood pressure of the subject 50 is measured on the spot at an arbitrary timing, and the pressure applied to the subject 50 is confirmed while being actually applied. You may make it press.
  • the electrical stimulation applied to the subject 50 to develop the muscle pump action is not strictly limited, but is 5 to 40% of the isometric maximum muscle strength, for example, 5 to 5 of the isometric maximum muscle strength. It is set so as to include an electrical stimulus of intensity that induces 30% exercise (hereinafter, this electrical stimulus may be simply expressed as “5-30% stimulus”). Is appropriate. If the electrical stimulation is too strong, it may cause pain such as pain to the subject 50 or cause muscle fatigue, which makes it difficult to repeatedly apply electrical stimulation. Therefore, it is preferable to set the intensity
  • the maximum intensity of the electrical stimulation is typically set to about 10 to 40% of the isometric maximum muscle strength. Is more preferably about 20 to 30%.
  • the maximum intensity is more preferably 25% or less, and further preferably 20% or less.
  • the electrical stimulation applied to the subject 50 is preferably 10% or more, and more preferably 15% or more.
  • the mode of applying electrical stimulation includes electrical stimulation (5-30% stimulation) with a strength that induces exercise of 5-30% of isometric maximum muscle strength, as a preferred example. It can be varied in various ways as long as the object of the present invention is not impaired. For example, a combination of a plurality of 5 to 30% stimuli may be applied. For example, specifically, a combination of 10% stimulation ⁇ 10% stimulation ⁇ 20% stimulation is exemplified. Further, for example, 5 to 30% stimulation may be applied in combination with other electrical stimulation. For example, specifically, 1% stimulation ⁇ 5% stimulation ⁇ 10% stimulation ⁇ 20% stimulation, etc. Giving as a combination of these is exemplified.
  • Such muscle contraction can be induced, for example, by applying a low frequency of 1 Hz to less than 1000 Hz, a medium frequency of 1000 Hz or more, or a high frequency of 10,000 Hz or more to the muscle. More preferably, as will be described in detail later, it is shown as a preferred example that a high-band signal and a low-band signal at a low frequency of 1 Hz or more and less than 1000 Hz are further combined with an arbitrary pulse waveform to oscillate.
  • the muscle contraction is performed by placing a pair of pad-shaped conductors 22 of the electrical stimulation applying unit 20 in the vicinity of both ends of muscle fibers of the muscle to be contracted. After pasting, it can be suitably induced by supplying a current between the conductor portions 22.
  • the isometric maximum muscle strength is, for example, knee extension muscle strength that can be recognized as a representative value of lower limb muscle strength, in a state where the knee joint is bent at 90 degrees in the sitting position, and the ankle joint is placed on a bed or the like with Velcro tape or the like. It can be obtained by measuring the maximum voluntary muscle tension (MVC) when fixed or the like.
  • MVC maximum voluntary muscle tension
  • Such maximum voluntary muscle tension can be measured, for example, by the following method using an isokinetic muscle strength measuring device. Specifically, first, the subject is seated on a chair (sitting position), and the chest and abdomen are fixed to the chair with a seat belt. Then, the living body part having the muscle to be measured is fixed to the measuring lever of the isokinetic muscle strength measuring device.
  • the right neck joint of the subject's right leg is set to 90 degrees with the arm lever of the isokinetic muscle strength measuring device as the arm lever. Fix in the hold state. In such a state, when the subject is subjected to knee joint flexion and extension exercise at 0 degree / second with the maximum effort, the knee extension is performed several times (for example, about 2 to 5 times). Measure the peak torque when At this time, each bending and extending movement is continuously performed while securing a sufficient time interval. The maximum value of the peak torque thus obtained can be set as the isometric maximum muscular strength.
  • Such isometric maximal muscle strength can be expected to increase with the use of the vascular endothelial function improving device disclosed herein. Therefore, when the device is used over a long period (for example, one month or more).
  • the isometric maximum muscle strength is measured again every time a certain period (for example, about one week to one month) elapses.
  • index can also be employ
  • the vascular endothelial function improving device 1 disclosed herein may include a fixture 40 for preventing the limbs and the like from rising (bounce-up) as shown in FIG. 3, for example.
  • Such a fixture 40 may be disposed, for example, in a chair that can be placed in a sitting position when the living body is in a resting state, a bed that is placed in a horizontal position in a resting state, or the like.
  • the form of the fixture 40 is not particularly limited.
  • it may be a belt-type fixing device 40 disposed on a chair or a bed.
  • FIG. 3 is a diagram illustrating a configuration of the vascular endothelial function improving device 1 provided with a reclining chair 48 that can change the inclination angle of the backrest and the footrest.
  • the footrest of the reclining chain 48 is provided with a belt-type fixture 40.
  • the fixture 40 includes, for example, a footrest portion 42, a belt portion 44, a tightening portion 46, and the like. These are configured to be movable to an arbitrary position of the footrest according to the physique of the living body.
  • the pressure applying means 10 and the electrical stimulus applying means 20 are attached to the right lower limb 52 of a living body in a sitting position to try to improve the vascular endothelial function of the right lower limb 52.
  • the living body places the lower limb 52 on the footrest portion 42 and fastens the vicinity of the buttocks of the right lower limb 52 with the belt portion 44 and the tightening portion 46 for tightening the belt portion.
  • the lower limb 52 can be fixed to the reclining chair 48. Thereby, it is possible to prevent the lower limbs 52 from involuntarily jumping up due to the electrical stimulation applied by the electrical stimulation applying means 20, and to improve the vascular endothelial function in a safer and more resting state.
  • FIG. 3 shows the fixture 40 for fixing the right lower limb 52, a fixture having the same configuration may be attached to the left lower limb 54.
  • an upper right limb fixture and a left upper limb fixture having the same configuration may be attached.
  • the fixing device 40 fixes at least one of the four limbs, and in consideration of preventing involuntary jumping due to the applied electrical stimulation, only the electrical stimulation is applied. May be used.
  • the pressure applying means 10 and the electrical stimulus applying means 20 are attached to a plurality of living body parts such as the left and right lower limbs 52 and 54 and the left and right upper limbs 56 and 58, respectively.
  • the above pressure and electrical stimulation are applied.
  • the giving of each of the living body parts may be performed at the same time, or may be performed sequentially from any of the living body parts.
  • pressure and electrical stimulation can be applied to each living body part for a predetermined time (for example, 10 minutes).
  • stimulation can be applied in the order of the left upper limb, the left lower limb, the right lower limb, and the upper right limb.
  • pressure and electrical stimulation can be applied a predetermined number of times (for example, once or twice or more).
  • a pressure stimulus and an electrical stimulus are applied once to one of the left and right lower limbs, and then applied to the other.
  • the pressure stimulation and the electrical stimulation can be repeatedly applied once. More preferably, when the pressure applying means 10 and the electrical stimulus applying means 20 are attached to a plurality of parts, repeatedly applying the pressure and the electrical stimulus to the living body part in order a predetermined number of times (for example, once). A preferred example is to do this.
  • the shear stress generated in the artery can be confirmed as an acute effect by using, for example, a blood flow-dependent vasodilatation reaction (% FMD) as an index by an FMD inspection method or the like.
  • % FMD blood flow-dependent vasodilatation reaction
  • the effect over a longer period can be confirmed in the same manner.
  • the device for improving vascular endothelial function disclosed herein is used for 1 hour per day for 14 days, it can be confirmed by an increase in% FMD.
  • FIGS. 7 and 8 are graphs for simply explaining the relationship between the pressure stimulus applied to the living body, the timing of the electrical stimulus, and the intensity (signal form).
  • (A) shows the waveform of the stimulus signal of the pressurizing stimulus.
  • 7 (B1) to (B3) and (C1) and (C2) in FIG. 8 show the waveforms of stimulation signals of electrical stimulation.
  • pressurization by the pressure applying unit alternately repeats a pressurization period p in which pressurization is performed and a rest period ta in which pressurization is released.
  • the pressure stimulation is preferable because it can be applied intermittently in this way to achieve appropriate blood flow inhibition and release. In other words, it is preferable to apply pressure in a pulsed manner.
  • the pressurization period p and the rest period ta can be any time determined between about 15 seconds and 45 seconds, and preferably any time determined between about 7 seconds and 13 seconds, for example, about 10 seconds. Is shown as a preferred example.
  • the rest period is, for example, any time determined between about 15 seconds to 45 seconds, preferably any time determined between about 15 seconds to 40 seconds, for example, about 20 seconds to 30 seconds. It is shown as a preferable example that it is set to any time determined between them.
  • the electrical stimulation by the electrical stimulation applying means can be applied during a period including at least a part of the rest period ta of the pressurized stimulation.
  • the timings of the electrical stimulation periods e1 to e3 are not particularly limited as long as the periods include the rest period ta.
  • the electrical stimulation periods e1 to e3 are preferably set so as to be included in the rest period ta in which the pressurization is released. According to such timing, the blood flow that has been inhibited by pressurization can be efficiently swept away into the muscle contraction, and the vascular endothelial function can be improved more effectively.
  • the electrical stimulation period e1 may start simultaneously with the rest period ta as in the electrical stimulation period e1 shown in (B1). Further, like the electrical stimulation period e2 shown in (B2), the electrical stimulation period e2 may be included in the middle of the rest period ta. Moreover, like the electrical stimulation period e3 shown in (B3), the electrical stimulation period e3 may end simultaneously with the rest period ta.
  • the electrical stimulation period e for applying electrical stimulation and the rest period t for which pressurization is released are alternately repeated.
  • electrical stimulation periods e1 to e3 for applying electrical stimulation and rest periods t1 to t3 in which pressurization is released are included. Each can be repeated alternately.
  • the electrical stimulation periods e1 to e3 for example, the above 5 to 30% stimulation can be applied.
  • the electrical stimulation period e at a timing such that the electrical stimulation period e is continuously performed after the pressurization in the pressurization period p from the viewpoint of effectively expressing the muscle pump action.
  • the following modes are exemplified as a preferred form of the timing of applying pressure stimulation and electrical stimulation.
  • (1) The electrical stimulation is applied together with the start of the pause period of the pressure stimulation.
  • the above form (1) can be typically realized by, for example, a combination of the pressure stimulus of FIG. 7A and the electric stimulus of (B1). Although it cannot be generally described because it depends on the pressure strength and the electrical stimulus strength, it is not preferable to apply the pressure stimulus and the electrical stimulus simultaneously with a strong strength in consideration of the burden on the living body. Therefore, the electrical stimulation is immediately applied after the pressurization stimulus while shifting the pressurization period p and the electrical stimulus period e. By adopting such a stimulus imparting form, it is possible to eliminate the possibility of excessive stimulus imparting to the living body due to the overlap of the pressure stimulus and the electrical stimulus, and to effectively generate shear stress in the vascular endothelium. it can.
  • (A) pressurization stimulus and (B1) to (B3) electrical stimulus both have a signal wave form (stimulus intensity form) as a square wave.
  • the signal waveforms of the stimulus and the electrical stimulus are not particularly limited.
  • the pressure stimulus and the electrical stimulus may be a sine wave, a triangular wave, a ramp wave, an arbitrary waveform, and the like, independently of each other.
  • the above form (2) can be considered when, for example, the pressurization strength in the pressurization period p changes with time, as shown in FIG.
  • the strength and form of the pressure stimulus as long as a pressure of about (SBP + 10) to (SBP + 50) mmHg can be applied to the living body as described above. Therefore, the timing of applying electrical stimulation can be changed according to the form of pressure stimulation.
  • the pressure stimulus in FIG. 8A has a sine wave-like stimulus form.
  • the electrical stimulation is performed at the same time as the pressurization stimulus if it is after the pressurization by the maximum pressure of the pressurization stimulus of (A). Can be applied.
  • the pressurization period p and the electrical stimulation period e1 or e2 may overlap.
  • it is preferable because it can effectively generate stronger shear stress on the vascular endothelium while suppressing excessive stimulus application to the living body due to the overlap of the pressure stimulus and the electrical stimulus.
  • blood stagnation and congestion at the extremities due to an excessive increase in blood pressure can be suppressed.
  • the electrical stimulation periods e1 to e3 may not be constant.
  • the electrical stimulation period e may be determined by arbitrarily combining the electrical stimulation periods e1 to e3 exemplified in the above (B1) to (B3).
  • two or more electrical stimulation periods may be provided for one pressurization. According to such a configuration, the blood flow velocity can be effectively increased without excessively increasing the blood pressure of the artery.
  • the electrical stimulation period e is preferably constituted by, for example, a low frequency of 1 Hz or more and less than 1000 Hz, a medium frequency of 1000 Hz or more and less than 10,000 Hz, or a high frequency of 10,000 Hz or more. More preferably, a high-band signal of about 50 Hz or more and about 500 Hz or less and a low-band signal of about 1 Hz or more and less than 50 Hz among low frequencies may be further combined in an arbitrary pulse waveform.
  • Various modes can be considered for the form of the combination of the frequency and the number of the high-band signal and the low-band signal to be combined.
  • a plurality of low-band signals for example, 20 Hz
  • a plurality of high-band signals for example, 200 Hz
  • the combination of the high band signal and the low band signal is specifically exemplified as follows, for example. That is, first, a plurality of the high-band signals are output, and then a plurality of the low-band signals are output to obtain a composite pulse signal. And by providing such a composite pulse signal alternately and repeatedly with a composite pulse pause period in which no signal is output, the electrical stimulation period e can be obtained.
  • the high-band signal is preferably about 50 Hz or more and 400 Hz or less, and more preferably about 100 Hz or more and 200 Hz or less.
  • the number of high-band signals is preferably 2 or more and 4 or less, and more preferably 2 or more and 3 or less.
  • the low-band signal is preferably about 1 Hz to 30 Hz, more preferably about 10 Hz to 25 Hz.
  • the number of low-band signals is preferably 2 or more and 20 or less, and more preferably 4 or more and 15 or less.
  • the pulse pause period is preferably not less than 300 milliseconds and not more than 900 milliseconds, and more preferably not less than 400 milliseconds and not more than 800 milliseconds.
  • the electrical stimulation period e can be any time determined between about 5 seconds to 15 seconds, A preferable example is a time that is preferably set between about 7 seconds and 13 seconds, for example, about 10 seconds.
  • the rest period t can be any time determined between about 15 seconds and 60 seconds, preferably any time determined between about 15 seconds and about 45 seconds, and more preferably about 15 seconds. It is exemplified that any time defined between about 40 seconds and about 40 seconds, for example, any time defined between about 20 seconds and about 30 seconds. According to the technology disclosed herein, by adopting the composite pulse signal as described above, it is possible to set the rest period t to be relatively short without causing fatigue to the living body.
  • such electrical stimulation is performed by pasting a pair of pad-shaped conductors 22 of the electrical stimulation applying device in the vicinity of both ends of muscle fibers of a muscle to be contracted. It is preferable to apply between the conductor portions 22.
  • the application of the above pressurization and electrical stimulation is applied to the living body, for example, over a period of 5 minutes or more as a whole, more preferably 10 minutes or more and 100 minutes or less, and more preferably 20 minutes or more and 60 minutes or less. can do. That is, according to the vascular endothelial function improving device disclosed herein, for example, pressurization and electrical stimulation can be applied to a living body without causing pain or muscle fatigue to the living body. And pressurization and electrical stimulation programs. In addition, according to the vascular endothelial function improving device disclosed herein, it is possible to effectively generate shear stimulation to the arterial endothelium, and for example, it is possible to generate a certain amount of shear stimulation in a shorter time. It becomes.
  • the strength of pressurization for example, ⁇ (the magnitude of 0 ⁇ ⁇ ⁇ 50) when the compression strength is (SBP + ⁇ ) mmHg) and frequency (additional)
  • the frequency of pressurization determined by the pressure period p and the rest period ta) is variously changed, and the influence on the generation of shear stimulation is examined. In these processes, no matter how the intensity and frequency of pressurization are adjusted, it is confirmed that, for example, it is not possible to effectively generate shear stimulation only by pressurization, and the vascular endothelial function cannot be significantly increased. ing.
  • muscle activity is effectively induced by electrical stimulation applied in combination after pressurization, and the magnitude (degree) of such muscle activity provides effective stimulation (shear stimulation) for improving vascular endothelial function.
  • effective stimulation to the extent that improves vascular endothelial function is realized for the first time by the synergistic action of pressurization and electrical stimulation.
  • the subjects 50 were 5 healthy male college students who had no regular training experience.
  • the subject 50 first measured the systolic blood pressure using a sphygmomanometer, and then measured the isometric maximum muscle strength of the upper arm (isometric maximum elbow flexion strength).
  • An isometric strength measuring device manufactured by Minato Medical Science Co., Ltd. was used for measuring the isometric maximum muscle strength.
  • the forearm of the subject's right arm was placed on the arm lever with the right elbow joint at 90 degrees.
  • the elbow joint flexion movement was performed with a maximum effort and a sufficient time interval from a state in which the subject was fixed (0 degree / second) at 20 degrees elbow flexion (60 degrees shoulder abduction, maximum forearm rotation). It was carried out 3 times continuously while ensuring.
  • the peak torque value of the flexion movement of the right arm was measured, and the maximum value was defined as the isometric maximum muscle strength (isometric maximum elbow flexion strength).
  • pressurization and electrical stimulation were applied to the upper limbs 56 and 58 of the subject 50 using the vascular endothelial function improving device 1 disclosed herein.
  • the subject 50 was comfortably seated on the bed in the farrer position, and the pressure applying means 10 and the electrical stimulus applying means 20 were respectively attached to the forearm portion and the upper arm portion of the right arm to be rested.
  • pressurization and electrical stimulation were applied to each subject 50 under the following conditions (1) to (5).
  • Application of pressurization and electrical stimulation by the vascular endothelial function improving device 1 was performed on five subjects 50 for each of the conditions (1) to (5).
  • the above-mentioned “stimulation of 20% of the maximum isometric muscle strength” is typically “20 Hz following two 200 Hz high-frequency pulses” although there are slight differences depending on the subject.
  • a pulse group composed of “eight low-frequency pulses” was repeated for 10 seconds with a rest period of about 600 ms.
  • the arterial vascular endothelial function evaluation was performed on the right upper arm of each subject using an arterial vascular endothelial function evaluation apparatus (manufactured by Unex Corporation, MS0000107). Specifically, regarding the presence or absence of compression at systolic blood pressure + 20 mmHg shown in the condition (1), two types of 10% and 20% of the maximum isometric contraction shown in the above conditions (2) and (3) The blood flow-dependent vasodilator response (% FMD) of the brachial artery of the subject after the application of four types of electrical stimulation that can induce muscle strength was measured.
  • % FMD blood flow-dependent vasodilator response
  • vascular endothelial function improving device 1 Using the vascular endothelial function improving device 1, the arterial endothelial function of the upper limbs 56 and 58 of the subject 50 was improved, and the effect was evaluated.
  • the subjects 50 were three healthy male university students A, B, and C who did not perform regular training.
  • the subject 50 measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) with a sphygmomanometer, and the pressure applied by the pressure applying means 10 (compression strength) was determined from these values. .
  • SBP systolic blood pressure
  • DBP diastolic blood pressure
  • the isometric maximum muscle strength of the upper arm was measured in the same manner as in the first embodiment, and the electrical stimulation intensity (20% MVC) by the electrical stimulation applying means 20 was determined from the measurement result. These results are shown in Table 1 below.
  • the confirmation of the vascular endothelial function improving effect was performed according to the following procedure. That is, first, (1) the subject was rested for 20 minutes, and then FMD measurement before treatment was performed. (2) After 20 minutes of rest, the arterial endothelial function improving treatment by the vascular endothelial function improving device 1 was performed for 30 minutes. (3) Then, the improved FMD measurement was performed as quickly as possible. The time from the start of the treatment for improving arterial endothelial function to the start of FMD measurement is shown in Table 1 above.
  • FMD measurement is performed using an FMD inspection apparatus based on high-resolution ultrasound (manufactured by UNESCO Corporation, MS0000107), and the improvement effect of arterial endothelial function is evaluated using% FMD,% L-FMC, and% FMTD as indices. It was.
  • % FMD is a value indicating a dilation ratio in which a blood vessel is dilated by the blood flow after the release of blood transfusion compared to the rest before the blood transfusion, and is calculated based on the following equation.
  • % L-FMC low-flow-mediated constriction
  • % FMTD is a value indicating the rate at which the blood vessels are dilated by the blood flow after the release of the blood transfusion, based on the blood vessel diameter immediately after the blood transfusion is released and not the blood vessel diameter at rest before the blood transduction. And calculated based on the following formula.
  • “the blood vessel diameter at rest before blood transduction”, “the blood vessel diameter immediately after the blood transfusion is released”, and “the maximum blood vessel diameter after the blood transfusion is opened” in the formula can be obtained by observation with a high-resolution ultrasonic method using an FMD inspection device, respectively.
  • the diameter of the arterial blood vessel to be improved in function before resting the diameter of the blood vessel immediately after the blood is released, and the maximum diameter of the blood vessel after the blood is released.
  • the results of FMD measurement are shown in Table 2 below.
  • Table 3 shows detailed data on blood vessel diameter and measurement results of blood flow velocity in FMD measurement.
  • the vascular endothelial function improving apparatus 1 was used to apply pressure and electrical stimulation to the upper limbs 56 and 58 of the subject 50.
  • the subject 50 was easily seated on the bed in a farer position, and the pressure applying means 10 and the electrical stimulus applying means 20 were attached to the forearm and upper arm of the right arm, respectively.
  • the cuff body 12 of the pressure applying means 10 was attached to the forearms of the upper right limbs 56 and 58 of the subject 50.
  • the conductor portion 22 of the electrical stimulus applying means 20 is mounted in the vicinity of the muscle head and muscle tail so as to sandwich the muscle abdomen of the right upper biceps of the subject 50. Then, compression stimulation and electrical stimulation were applied to the subject 50 in a resting state under the following conditions.
  • the% FMD value increased by 1% or more after the treatment with the vascular endothelial function improving apparatus for two of the three subjects.
  • subject A increased by 3% or more.
  • the% FMTD value considering L-FMC increased by about 1-2% in all subjects.
  • the vascular endothelial function is improved by the treatment for only 30 minutes. It can be expected that a further improvement effect can be permanently obtained by continuously performing the improvement treatment of the vascular endothelial function.
  • Such a technique is considered to be useful for, for example, prevention and treatment of arteriosclerosis and heart disease.
  • this invention was demonstrated by suitable embodiment, such description is not a limitation matter and of course various modifications are possible.
  • this invention can also include the following structures as evident from the above description.
  • Pressure applying means for applying a pressure that inhibits blood flow to a part of an artery of the living body, and inducing contraction of the muscle to the muscle including the artery on the central side of the site to which the pressure is applied.
  • An apparatus for improving vascular endothelial function comprising: electrical stimulation applying means for applying electrical stimulation to be obtained. 2.
  • the pressure applying means intermittently applies pressure by a pressurization period in which pressurization is performed on the artery and a rest period in which the pressurization is released, and the electrical stimulus imparting means has the rest
  • the above-mentioned vascular endothelial function improving device configured to apply electrical stimulation to the muscle during at least a part of the period.

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Abstract

La présente invention concerne un dispositif d'amélioration de fonctions endothéliales vasculaires avec lequel il est possible d'améliorer les fonctions endothéliales vasculaires d'artères sans réaliser d'exercice dynamique. Le dispositif d'amélioration de fonctions endothéliales vasculaires qui est décrit dans la description est doté d'un moyen d'application d'une pression qui applique, sur une partie des artères d'un organisme, une pression destinée à bloquer le flux sanguin, et un moyen d'application d'une stimulation électrique qui applique, sur un muscle qui contient une artère, une stimulation électrique qui peut induire une contraction du muscle. Le moyen d'application d'une pression applique de façon intermittente une pression par le biais d'une période de mise sous pression durant laquelle une pression est appliquée sur l'artère, et une période de report durant laquelle la mise sous pression est relâchée. Le moyen d'application d'une stimulation électrique est configuré pour appliquer une stimulation électrique sur le muscle durant une période qui comprend au moins une partie de la période de repos.
PCT/JP2014/084413 2013-12-26 2014-12-25 Dispositif d'amélioration de fonctions endothéliales vasculaires WO2015099090A1 (fr)

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Cited By (6)

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CN106618906A (zh) * 2017-02-20 2017-05-10 金华市中心医院 用于血管介入术后的下肢制动固定器
EP3407962A4 (fr) * 2016-01-29 2019-02-13 John M. Owen Procédé de traitement de dysfonctionnement vasculaire par écoulement vasculaire amélioré et activation hémodynamique des processus d'autocrine et de paracrine
CN109481264A (zh) * 2018-12-24 2019-03-19 贾文元 一种具有体外反搏功能的按摩椅
WO2019169240A1 (fr) 2018-03-01 2019-09-06 Adventus Ventures, Llc Systèmes et procédés de contrôle de la pression artérielle
WO2020198158A1 (fr) * 2019-03-22 2020-10-01 VasoActiv Biomedical Technologies LLC Dispositif de traitement d'un dysfonctionnement endothélial et d'affections associées par hémodynamique
WO2021193035A1 (fr) * 2020-03-27 2021-09-30 テルモ株式会社 Système d'électrostimulation

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EP3407962A4 (fr) * 2016-01-29 2019-02-13 John M. Owen Procédé de traitement de dysfonctionnement vasculaire par écoulement vasculaire amélioré et activation hémodynamique des processus d'autocrine et de paracrine
CN106618906A (zh) * 2017-02-20 2017-05-10 金华市中心医院 用于血管介入术后的下肢制动固定器
WO2019169240A1 (fr) 2018-03-01 2019-09-06 Adventus Ventures, Llc Systèmes et procédés de contrôle de la pression artérielle
EP3758595A4 (fr) * 2018-03-01 2021-04-14 Adventus Ventures, LLC Systèmes et procédés de contrôle de la pression artérielle
US11357981B2 (en) 2018-03-01 2022-06-14 Adventus Ventures, Llc Systems and methods for controlling blood pressure
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WO2020198158A1 (fr) * 2019-03-22 2020-10-01 VasoActiv Biomedical Technologies LLC Dispositif de traitement d'un dysfonctionnement endothélial et d'affections associées par hémodynamique
WO2021193035A1 (fr) * 2020-03-27 2021-09-30 テルモ株式会社 Système d'électrostimulation

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